Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercandipine

Refer verapramil-

Increases digoxin blood levels. May cause hypotension,angina and cardiac failure if concurrently used with beta blockers,(uncommon).

Potentiates antihypertensives,

Plasma quinidine levels may be reduced.

Levels of theophylline and phenytoin increased.

Synergism with beta blockers

Reverses depression of cardiac function,caused by beta blkrs.

Cimetidine increases bioavailability and potentiates hypotensive action.

Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine, Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercandipine

Refer Verapramil-

.

Calcium Channel Blockers include - Bepridil, Diltiazem, Felodipine, Isradipine, Nicardipine, Nifedipine,  Nimodipine, Verapramil, Amlodipine, Nisodipine, Clevidipine, Lercandipine
 Refer verapramil-
 

NIFEDIPINE-

Generally not serious, rarely requires discontinuation or dosage adjustment
   

CNS -               Dizziness/lightheadedness   25%, Headache 22 %
                        Weakness/shakiness/jitteriness 10%
                         Nervousness < 7%,
                         Parathesia , Somnolence  Asthenia, Insomnia 3%,
                        Sleep disturbances, Blurred vision  2%,
                        Abnornal dreams, Tinnitus , Maliase < 1%

GASTROINTESTINAL -  Nausea 10%, diarrhea, Constipation, 
                                          Abdominal discomfort,cramps, dyspesia,
                                          Dry mouth/thirst, flatulance  3%,
                                          Dyspeusia, Vomiting,  < 1%

CARDIOVASCULAR -    Peripheral edema  30%,
                                         Palpitation, Pulmonary edema  7%,
                                         Congestive heart failure,Myocardial  infarction 6%
                                        Hypotension 5% 
                                        Syncope , Arrhythmias, Tachcardia < 1%

DERMATOLOGIC -       Dermatitis, rash, Pruritis, urticaria  3%
                                       Hair loss , 1%

HEMATOLOGIC -        Anemia, Leukopenia, Thrombocytopenia ,
                                     Petechiae, Purpura   1%

OTHER-                      Flushing 25%,
                                    Muscle cramps, Pain, Inflammation,   8%,
                                    Cough , Rhinitis 6%
                                    Joint stiffness, Arthiritis, Mituration disorder,
                                    Noctiria, Dysuria, frequency ,  Sexual difficulties  3%
                                    Sweating < 2%  
                                   Nasal or chest  congestion, Sinusitis,  < 6%

Hypersens,acute M.I.,hypotension,pregnancy,cardiogenic shock.

Special precautions:

Fixed ventricular outflow obstruction.Has no inherant antiarrhythmic action.

Withdrawal of beta blkrs should be gradual.

May potentiate existing hypertensive therapy.

Poor cardiac reserve.

Large doses of beta blkrs..

Diabetes.

Safey for use in pregnancy and lactation not established.

CCF.Heptic impairment.

Date of Approval      2008

Indications:

Vasospastic angina

Dosage:

Individualise dose. Initial- 10mg 3 times a day. Usual range is 10 to 20mg 3 times a day. Dosage more than 120mg is not recommended.

Calcium channel blockers-

1.Take the medicine exactly as directed by the physician.

2.Swallow the tablet whole,without crushing or chewing it. However if advised by the doctor, you may break into half.

3.Take the medicine with food or milk.

Refer- Verapramil - Calcium Channel blocker

Refer - Verapramil- Calcium Channel blocker

Refer - Verapramil - Calcium blocker